Ranjbar Amene, Mehrnoush Vahid, Montazeri Farideh, Darsareh Fatemeh, Shahrour Walid, Roozbeh Nasibeh, Banaei Mojdeh, Saffari Mozhgan
Fertility and Infertility Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, IRN.
Department of Urology, Northern Ontario School of Medicine, Thunder Bay, CAN.
Cureus. 2023 Sep 4;15(9):e44643. doi: 10.7759/cureus.44643. eCollection 2023 Sep.
Spontaneous rupture of the urinary bladder (SRUB) during pregnancy is a potentially fatal event that necessitates immediate surgery. The aim of this systematic review is to determine the symptoms, causes, associated factors, and prognosis of SRUB in pregnancy. We searched the literature from inception until December 2022 using the Cochrane Central Register, PubMed, EMBASE, ProQuest, Scopus, and Google Scholar. Articles not in English and those unrelated to the topic were excluded. The JBI Critical Appraisal Checklist for case reports was employed for the risk of bias assessment. The search strategy yielded 312 citations; 29 full-text articles were evaluated for eligibility after screening. Five case reports were included in this review. The age range of the cases was 27-39 years. Four cases were in their second trimester of pregnancy, and one was in her third. Two cases had undergone previous cesarean sections, and one had an appendectomy and salpingectomy due to an ectopic pregnancy. One case reported a history of alcohol and drug abuse. The most common symptoms were abdominal pain, abdominal distension, oliguria, voiding difficulty, hematuria, fever, and vomiting. The diagnosis of SRUB was primarily made via emergency laparotomy due to the patients' critical conditions. Beyond its diagnostic role, laparotomy was also the treatment method in all cases. Tear repair, antibiotic therapy, and urinary catheterization were all integral parts of the treatment. Four cases resulted in an uneventful pregnancy and a healthy, full-term baby. In one case, a hysterectomy was performed due to a combined uterus and bladder rupture. SRUB often presents with non-specific symptoms, leading to a delayed diagnosis. A high index of suspicion is essential when a pregnant woman exhibits urinary symptoms and severe abdominal pain, especially in those with a history of previous surgery. Early detection and treatment of SRUB are critical for an uneventful recovery.
妊娠期间膀胱自发性破裂（SRUB）是一种可能致命的事件，需要立即进行手术。本系统评价的目的是确定妊娠期间SRUB的症状、病因、相关因素和预后。我们使用Cochrane中心对照试验注册库、PubMed、EMBASE、ProQuest、Scopus和谷歌学术搜索了从创刊至2022年12月的文献。排除非英文文章和与该主题无关的文章。采用JBI病例报告关键评价清单进行偏倚风险评估。检索策略共获得312条引文；筛选后评估了29篇全文文章的 eligibility。本评价纳入了5例病例报告。病例的年龄范围为27至39岁。4例处于妊娠中期，1例处于妊娠晚期。2例曾接受过剖宫产，1例因异位妊娠接受过阑尾切除术和输卵管切除术。1例报告有酗酒和药物滥用史。最常见的症状是腹痛、腹胀、少尿、排尿困难、血尿、发热和呕吐。由于患者病情危急，SRUB的诊断主要通过急诊剖腹手术进行。除了其诊断作用外，剖腹手术也是所有病例的治疗方法。撕裂修复、抗生素治疗和导尿都是治疗的组成部分。4例妊娠过程顺利，产下健康足月婴儿。1例因子宫和膀胱联合破裂行子宫切除术。SRUB常表现为非特异性症状，导致诊断延迟。当孕妇出现泌尿系统症状和严重腹痛时，尤其是有既往手术史的孕妇，高度怀疑至关重要。早期发现和治疗SRUB对于顺利康复至关重要。
